HandsOn Greater Phoenix | YEC Application

YEC Volunteer Application

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Fields marked with an asterisk (*) are required.

Personal Information

First Name

Last Name

Date of Birth

Phone Number

Street Address

City

State

Zip Code

Participation

Driving Distance

What is the max. time in MINUTES you are willing to drive to your school site?

Are you able to commit to 2+ hours/week, for the duration of the school year?

Grade/Subject Preference

Check all grades and subjects you would are able to support.

Share your availability during a typical week. This does NOT set your schedule.

YEC Availability

Please check ALL the POSSIBLE days/times you could serve in the classroom. Evening hours (3-6pm) apply to High School only.

Experience and History

Highest Level of Education

Career Area/Job Sector 1

In what sector have you spent the longest duration of your working life (i.e. Marketing, Social Work, Business, Engineering, Real Estate, Retail, Homemaker, Elementary Education, currently Full Time Student, etc.)?

Career Area/Job Sector 2

In what other sector have you spent a significant duration of your working life?

Credentials/Certification

(NOT REQUIRED) If you have any special training or certifications (even if expired or out-of-state) that makes you highly qualified to work with K-12 students, please list the TITLE(s) of those credentials below.

References

Please list 3: Professional References #1 & 2 (Supervisor, coworker)- include Name, Phone &/or Email; #3 is a Personal Reference (friend, neighbor) Name, Phone &/or Email

Are you a U.S. citizen, national, or lawful permanent resident alien?

If you are a lawful permanent resident alien and you received your card after Jan. 1987, what is your registration number and card expiration date?

Have you ever been convicted, or adjudicated as a juvenile offender, of any criminal offense by either a civilian or military court, other than a minor traffic violation?

Are you currently under charges for any offense?

Are you currently on probation or parole?

How you heard about YEC?

Type your Initials and Date below if you agree with the following statement: CERTIFICATION: I certify that all of the statements made in this application are true, correct, and complete, to the best of my knowledge, and are made in good faith. I understand that misinformation or omission of information could result in disqualification and/or termination as a Your Experience Counts volunteer. I also give my consent for the background security check which is conducted annually for this program.

Initials & Date:

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